"PrEP for a lot of women, will be their entry point for access to care," noted Martha Cameron, Director of Prevention at The Women's Collective. "They are hearing about it for the first time and you see the surprise," she added. "The first part of the session is trying to convince people that it's real, it's out there, that it's for women and not just for MSM, and it works."
The Women's Collective is a non-profit organization in Washington D.C. that serves women of color who are HIV positive or at risk for HIV. They're working with the D.C. Department of Health on PrEP for Her, a new campaign that aims to increase knowledge about PrEP, or pre-exposure prophylaxis, among African-American Women. PrEP can be more than 90 percent effective in preventing HIV when taken daily.
Not everyone who is eligible for PrEP is aware of it, however, and that's where the health department along with their community partners hope to make a dent. CDC estimates that there are 1.2 million people in the nation who are eligible for PrEP: 38 percent are women. "This group hasn't really been targeted in any other initiative," noted Ashlee Wimberly, PrEP for Women Project Coordinator at the Washington AIDS Partnership, a similar initiative to bring PrEP awareness to women. "There's a very big gap."
Ms. Wimberly is referring specifically to women of color. "The most important thing that needs to be mentioned is that there has hardly been any campaign, social media strategies, even images out there that have targeted women in general and especially women of color with regard to PrEP," added Ms. Cameron.
17.2 percent of HIV diagnoses in 2014 in DC were among women; of all the women diagnosed, 91.2 percent were Black. Data from Gilead Sciences, the pharmaceutical company that makes Truvada® (the medication used for PrEP), showed an almost four fold increase in PrEP uptake between 2014 and 2015 among men, while the numbers of women taking PrEP remained stagnant.
PrEP for Her wants to change that. "It's exciting to see it come together," said Dr. Travis Gayles, Chief Medical Office at the D.C. Health Department. "I think for so long, especially around HIV, a lot of our resources haven't been targeted towards women." Dr. Gayles noted that while there are high numbers of men who have sex with men (MSM) impacted by HIV, and thus much of HIV prevention efforts focus on that population, it's exciting to have an effort that includes women as well.
However, prescribing PrEP isn't enough. "I'm a big believer that the easy part of PrEP is to write a prescription," Dr. Gayles said. Ms. Cameron agrees. "The drug is not the issue," she said. "The issue is you have to have follow-up medical care, and labs, and so on." Ms. Cameron noted that many of the women she works with face barriers to sustained care, from financial instability, to housing security, being in violent relationships, and having mental health or substance use concerns. All those aspects must be addressed in order to reap the benefits from PrEP. Dr. Gayles concurs. "There are a lot of factors that go into adherence beyond just the patient's desire to take the medication," he said.
Ms. Wimberly added that the PrEp for Women Initiative aims to reach 5,000 women and 300 doctors in D.C. to increase knowledge and PrEP awareness through social media and traditional marketing over the next two years. The conversation is about empowering women and PrEP helps HIV negative women do that by putting prevention in their hands, in the form of a pill. Everyone agrees that messages about PrEP must be relevant for women and their sexual circumstances. "I think we definitely have to make sure that the information is accessible and we relay it in a way that connects with our intended audience," Ms. Wimberly said. "If we're going to be effective, that's a key piece to it."
The D.C. Health Department launched the PrEP for Her initiative this year with funding from the Centers for Disease Control and Prevention and the MAC AIDS Foundation. In July 2016, their STD clinic began offering PrEP to patients for the first time. The Washington AIDS Partnership launched the D.C. PrEP for Women initiative in July 2016. This fall, the Partnership will release a request for applications to support innovative projects aimed at increasing PrEP knowledge and utilization in Washington, D.C. Additionally, the D.C. Health Department provides funding to The Women's Collective for some of their HIV prevention efforts.
The views expressed herein do not necessarily reflect the official policies of the City and County of San Francisco.